ADA Brief on Dentist Income

[Sergio Estavillo]

Here's a link to a summary article:

http://www.dmdtoday.com/news/how-dentists-income-has-faired-since-the-recession?utm_source=Informz&utm_medium=Dentist%27 s+Money+Digest&utm_campaign=DMD%5FNewsletter%5F12% 2D21%2D16

A few quotes for the article and the actual ADA Brief:

"In 2015, general dental practitioner net earnings averaged $179,960. Those owning their own practices averaged $195,200 while non-owners netted approximately $132,370. Dental specialists brought home more, averaging around $320,460.

However, when adjusted for inflation, the average net income for all general dental practitioners has decreased substantially since the peak value was recorded in 2005. That year, the average net income was $219,638.

On the supply side, new research shows that the supply of dentists is expected to increase in the coming years. If the dental sector is indeed entering an era of flattening total dental spending and an increasing supply of dentists, this will have important implications for the bottom line of dental practices."

[Noah]

My partner is a dentist and these numbers seem accurate. Tuition is insane as well. Being a dentist doesn't seem like that rosy of a proposition anymore.

http://dentistry.usc.edu/programs/dds/cost-of-attendance/

[Zaphod]

Noah wrote:

My partner is a dentist and these numbers seem accurate. Tuition is insane as well. Being a dentist doesn’t seem like that rosy of a proposition anymore.

http://dentistry.usc.edu/programs/dds/cost-of-attendance/

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Well, USC is one of the most expensive schools around, for anything. You also get LA cost of living to go with that. Though they are on main campus which is considerably more fun than the med schools.

[VagabondMD]

I have spoken to dentists, prospective dentists, and the parents of prospective dentists over the years, all of whom believed that the financial outlook for dentists was much brighter than for MDs (with the exception of my father, a retired orthodontist!).

The argument was that dentists run a "cash" business and could charge whatever they wanted--and get it--with minimal interference from insurance companies and government entities. I always thought that this was overly optimistic and am not surprised that income among dentists may also be stagnant. After all, the same people who do not have money to pay for health insurance, deductibles, medication copay and other out of pocket medical costs don't suddenly have an extra $5000 for crown and bridge work-- or do they?

[Zaphod]

Vagabond MD wrote:

I have spoken to dentists, prospective dentists, and the parents of prospective dentists over the years, all of whom believed that the financial outlook for dentists was much brighter than for MDs (with the exception of my father, a retired orthodontist!).

The argument was that dentists run a “cash” business and could charge whatever they wanted–and get it–with minimal interference from insurance companies and government entities. I always thought that this was overly optimistic and am not surprised that income among dentists may also be stagnant. After all, the same people who do not have money to pay for health insurance, deductibles, medication copay and other out of pocket medical costs don’t suddenly have an extra $5000 for crown and bridge work– or do they?

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That seems incredibly not well thought out. In general if we're talking about overall scale the great majority of people dont pay enough attention to their teeth and unless they are having a problem will most definitely not pay anything for it if they dont have to. Its still viewed as a luxury more than an absolute necessity, and kind of an out of sight out of mind thing. There is always a saturation point, and their message hasnt been great to the overall public, but seems to have been amazing to prospective students. They need to convince the population how necessary they are and make it more of a part of their life, I guess their national society should be on this. I am unaware of any messaging campaign, which means even if they have one it isnt working.

General dentists have succumbed to insurance as well and many wouldnt survive without it (what my dentist tells me). Now my ortho guy might be killing it, but he was established a couple decades ago and his practice is always super busy and its very efficient and well run. But owners in any field that are good will have success.

[HandFellow]

I recently moved from New Mexico.  There was a group of dentists down there that were all making over 40k per month.  I have no idea how all these generalists were doing it.

[CM]

HandFellow wrote:

I recently moved from New Mexico.  There was a group of dentists down there that were all making over 40k per month.  I have no idea how all these generalists were doing it.

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Gross or net?

[HandFellow]

Not on the inside, but these guys were all living large.  My understanding is that was net.  the crazy thing was that it was largely a medicaid payor.  something was going on down there.

 

[retinadoc]

I feel that I've had more than my fair share of bad financial experiences with dentists. I feel that the care I got was highly determined by the quality of my insurance -- a million x-rays done before I even saw the doctor for a new patient cleaning appointment, asking me to come back for a deep cleaning which was to be done with oral anesthetic not injectable, trying to sell a bunch of dental equipment and cleaning supplies on my way out.

I'm not naive enough to think that this doesn't happen in medicine at all, but my history makes me wonder about the scruples of the profession.

[CM]

retinadoc wrote:

I feel that I’ve had more than my fair share of bad financial experiences with dentists. I feel that the care I got was highly determined by the quality of my insurance — a million x-rays done before I even saw the doctor for a new patient cleaning appointment, asking me to come back for a deep cleaning which was to be done with oral anesthetic not injectable, trying to sell a bunch of dental equipment and cleaning supplies on my way out.

I’m not naive enough to think that this doesn’t happen in medicine at all, but my history makes me wonder about the scruples of the profession.

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I've had similar experiences, albeit not as egregious.

[Complete_newbie]

Thats some shady stuff. There is no way their production is 40K/month net unless chucking whizzes left and right.

[LongInTheTooth]

As a retired dentist and CFP, I feel the older practitioners who own their own practices still do very well and have a nice lifestyle.  However, that cannot necessary be said for many of the younger dentists who now come out of dental school.  My observation the last few years for decreasing incomes is the growth of Dental Service Organizations (DSOs) funded by hedge funds, private equity firms, etc.  While the corporate practice of medicine and dentistry is illegal in most states, there is basically no enforcement.  The DSOs know that student loan debt requires an immediate job and offer low salaries.  Average the new dentists incomes with the older ones and you are now getting a decrease.

My daughter is a dermatologist.  Since there was no enforcement by states against the corporate practice of dentistry, the hedge funds and private equity funds are now expanding into the medical field.  These new MSOs are now rapidly buying practices and using the same strategy that they used in dentistry.  It will only be a matter of time before the same statistics appear with physicians.

 

[Complete_newbie]

This strategy is just not in densitry, or derm. Its in Rads, anesthesia, EM etc. This is critical to understand for any medical student or prospective medical student.

Incomes are stagnant and work has increased steadily. Everywhere.

[Rb52dds]

I've been a dentist for 14 years.... last 10 in private practice. I'm in the Midwest and most general dentist practice owners who are established that I know are working 32 hrs a week and netting around $400k (net not gross.... office gross is usually $1M+). There's nothing shady going on in any of these offices. The typical model here is high volume PPO. Most employ several hygienists and a decent size support staff.

My friends in New Mexico with similar offices easily make double that. The reasons I've hear are high needs and few practitioners since there is no dental school in state (not sure if that's still true). I think their reimbursements are also good with insurance fee schedules.

I don't take Medicaid and no one I know in my area does except for the fqhc because reimbursement is lower than the cost of providing services ($2 for an X-ray for example)

The student debt and DSOs have ruined the profession for new grads. I won't encourage my kids to be dentists unless I can pay their tuition. I saw that dentistry is the job with the most debt for the past few years. At one point I had around a million dollars in student loan and practice debt. The debt load and stress has taken years off my life. Burn out and suicide are high in our profession (like m.d.'s)

I always wonder about those statistics. I would say a dentists income is like a bell curve..... slowly climbing the first ten years...... and then slowly decreasing the last five...... but I'd guess the average for those owning during their peak years would be in the $300k-600k+ range. I wonder if they are just going off "salary" and not counting distributions taken?

Too bad most of the new grads will never be able to own and will be corporate slaves maxing out at $160k. It's very sad to see the fall of our profession and these slick corporations coming in and "overselling" dentistry. A friend recently told me she switched to a new dentist and she had 4 cavities her last dentist missed. One ended up with a root canal and crown. I find it unlikely she needed a crown and root canal and a bunch of fillings..... thinking some new grad and a corporation were behind it all. We see this more and more.... people coming to us for second opinions who were told they need a ton of treatment..... and they don't.

Those of you who posted about bad experiences, I'd encourage you to find a good established dentist by referral of a friend. You may very well have periodontal disease that needs to be treated with a deep cleaning/ scaling and root planing...... or you may have gone to a shitty corporation that is over treating. When in doubt get a second opinion.

So.... not sure if I want my kids following in my footsteps. It will be interesting to see where the next few years take us. I think everyone in medicine is in a similar situation....

[Zaphod]

Rb52dds wrote:

I’ve been a dentist for 14 years…. last 10 in private practice. I’m in the Midwest and most general dentist practice owners who are established that I know are working 32 hrs a week and netting around $400k (net not gross…. office gross is usually $1M+). There’s nothing shady going on in any of these offices. The typical model here is high volume PPO. Most employ several hygienists and a decent size support staff.

My friends in New Mexico with similar offices easily make double that. The reasons I’ve hear are high needs and few practitioners since there is no dental school in state (not sure if that’s still true). I think their reimbursements are also good with insurance fee schedules.

I don’t take Medicaid and no one I know in my area does except for the fqhc because reimbursement is lower than the cost of providing services ($2 for an X-ray for example)

The student debt and DSOs have ruined the profession for new grads. I won’t encourage my kids to be dentists unless I can pay their tuition. I saw that dentistry is the job with the most debt for the past few years. At one point I had around a million dollars in student loan and practice debt. The debt load and stress has taken years off my life. Burn out and suicide are high in our profession (like m.d.’s)

I always wonder about those statistics. I would say a dentists income is like a bell curve….. slowly climbing the first ten years…… and then slowly decreasing the last five…… but I’d guess the average for those owning during their peak years would be in the $300k-600k+ range. I wonder if they are just going off “salary” and not counting distributions taken?

Too bad most of the new grads will never be able to own and will be corporate slaves maxing out at $160k. It’s very sad to see the fall of our profession and these slick corporations coming in and “overselling” dentistry. A friend recently told me she switched to a new dentist and she had 4 cavities her last dentist missed. One ended up with a root canal and crown. I find it unlikely she needed a crown and root canal and a bunch of fillings….. thinking some new grad and a corporation were behind it all. We see this more and more…. people coming to us for second opinions who were told they need a ton of treatment….. and they don’t.

Those of you who posted about bad experiences, I’d encourage you to find a good established dentist by referral of a friend. You may very well have periodontal disease that needs to be treated with a deep cleaning/ scaling and root planing…… or you may have gone to a shitty corporation that is over treating. When in doubt get a second opinion.

So…. not sure if I want my kids following in my footsteps. It will be interesting to see where the next few years take us. I think everyone in medicine is in a similar situation….

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I dont think anyone doubts owners taking in a nice paycheck, but there are certainly hassles (employees, etc..) and a lot more risk for that higher income. The issue becomes newer grads feel like they can in no way take that risk of owning and starting a practice and thus take that corporate job that is steady. Its really too bad.